Home » Covid » Long COVID: What a Cardiologist Wants You To Know
The COVID-19 pandemic has had a significant impact globally, with millions of cases and deaths reported in the United States alone. This Expert Consensus Decision Pathway (Ref. Link) aims to provide guidance for clinicians caring for adults with cardiac symptoms such as chest pain, shortness of breath, palpitations, and fainting after SARS-CoV-2 infection. It addresses frequently asked questions and provides practical guidance in the absence of extensive clinical trial data. In this blog, we have tried to cover what cardiologists recommend and want you to know about long COVID.
Long COVID refers to a set of symptoms that persist for weeks or months after the acute phase of a COVID-19 infection has resolved. These symptoms can include fatigue, brain fog, and difficulty breathing, as well as others such as muscle aches, joint pain, and sleep disturbances. It is still not fully understood why some people experience Long COVID while others do not, but it is believed to be related to the severity of the initial infection and individual differences in the immune system’s response. SARS-CoV-2 has caused more than 600 million confirmed cases, with more than 6.5 million deaths as of November 2022, more than two years into the global pandemic. Though the pathophysiology and immunological response of long COVID conditions are still being studied most of the symptoms and risk factors are identified.
Symptoms of long COVID – The three most common symptoms of COVID-19 are fatigue, shortness of breath, and cognitive dysfunction (brain fog). People may experience many other symptoms, like chest pain, fever, muscle pains, loss of smell and taste, anxiety, and depression.
Risk factors of long COVID – Identified risk factors for long-term COVID include older age; pre-existing comorbidities including obesity, cardiovascular disease, chronic lung disease, kidney disease, hypertension, and diabetes mellitus; initial disease severity; and female sex.
How long does long COVID last – It’s still unclear how long the condition can persist. It may last for a few weeks, months, or a year. More research is required to track long-term COVID patients and determine when, ideally, their symptoms will subside.
Management of long COVID condition – Multidisciplinary approach is recommended to manage long COVID patients. A person who develops long COVID conditions should seek help from primary healthcare professionals and relevant specialists. These include rehab professionals, social care workers, psychosocial workers, and mental health professionals.
Vaccination and long COVID -There is yet to learn how vaccination directly impacts long COVID conditions. Vaccination helps prevent COVID-19 infection, which is the best way to avoid post-COVID-19 infection or long COVID. The use of vaccines also reduces hospitalization and reduces mortality.
Although COVID-19 primarily affects the lungs or respiratory system, the heart can also be affected. Cardiovascular complications have been reported in both symptomatic and asymptomatic COVID-19 patients. Twenty to thirty percent of hospitalized patients with severe COVID-19 have evidence of myocardial involvement.
COVID-19 can cause temporary and lasting damage to the heart tissue leading to the following conditions:
Myocarditis and Pericarditis: Inflammation caused by the virus impacts the heart, causing Myocarditis (inflammation of the heart) and Pericarditis (inflammation of the outer lining of the heart). The coronavirus can directly infect and damage the heart muscle, or the heart muscle can be damaged and inflamed by the body’s immune response to the virus.
Arrhythmias and Heart failure: COVID-19 can directly damage the heart causing Arrhythmias and heart failure in few patients. An estimated 10 to 20 % of patients have arrhythmias related to COVID-19 infection. You can track your heart rate and ECG continuously using a heart rate monitor such as Frontier X2.
Blood clots: Severe COVID-19 infection damages the inner walls (endothelial lining) of the blood vessels and also causes blood clots throughout the body. If the blood clot obstructs the heart or brain artery, it leads to heart attack and stroke.
Stress cardiomyopathy: Viral infections subject the body to stress, which results in heart muscle disorder that impairs the heart’s ability to pump blood efficiently. As soon as the infection resolves, the stress ends, and the heart can recover.
Cytokine storm: This is a severe complication of coronavirus. In response to a coronavirus infection, the body releases a surge of proteins called cytokines, which help cells communicate with one another and fight off the invaders. This standard defensive mechanism is exaggerated in some people, leaving them vulnerable to cytokine storms. This causes inflammation of different tissues and organs like kidneys, liver, and heart. Cytokine storms can also lead to cardiac arrhythmias.
Yes, long COVID affects the heart. Long COVID causes damage to the heart muscle, inflammation of the lining of the heart and blood vessels. It also causes arrhythmias, stress cardiomyopathy in some patients.
People with severe COVID may suffer multi organ damage which involves the heart, kidneys, skin and brain. Autoimmune conditions and inflammation are also possible. It is unclear how long these effects could potentially last. They may last for a few weeks, months or a year.
Long-term COVID causes heart damage, but you should not be concerned if you experience only fatigue after COVID, which is a common sign. Please see your doctor if you experience additional heart-related symptoms such as chest pain, dyspnoea, and palpitations.
The American Heart Association (AHA) recommends an echocardiogram(ECG) or cardiovascular magnetic resonance imaging (CMR) for patients with heart disease symptoms.
Myocarditis caused by COVID-19 can lead to heart failure and arrhythmias.
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